1/137. Central dislocation of the hip with complications.A case of severe central fracture-dislocation of the acetabulum is described. This lesion was complicated by a small-bowel rupture and occlusion of the iliac vessels. In order to reduce the dislocation, iliopubic osteotomy and excision of the hip joint capsule was necessary.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/137. Anterior femoroacetabular impingement after periacetabular osteotomy.As experience with the Bernese periacetabular osteotomy has grown, an unexpected observation in a group of patients has alerted the authors to the risk of a secondary impingement syndrome that may occur some time after the periacetabular osteotomy. This possibly may explain residual pain and limited range of motion in a larger group of patients. The impingement is produced by abutment of the femoral head or head to neck junction on the anterior rim of the properly aligned acetabulum. The symptoms are those of restricted flexion, and limited or absent internal rotation in flexion, with variable groin pain. magnetic resonance imaging studies may reveal acetabular labral disease and adjacent cartilage damage associated with the impingement. Lack of anterior or anterolateral offset between the femoral neck and head results in neck to rim contact when the hip is flexed and/or internally rotated. Before the periacetabular osteotomy this is compensated by the lack of anterior acetabular coverage, but after proper correction the mismatch becomes apparent. The authors recently have devised a routine during the periacetabular osteotomy procedure whereby after the acetabular fragment is corrected into the desired position, the joint is opened, visually inspected, and palpated for impingement with the hip flexed and internally rotated. When necessary, a resection osteoplasty of the femoral neck to head junction is performed to improve the head and neck offset and reduce the anterior contact. This, in the short term, has provided satisfactory prevention of postoperative impingement.- - - - - - - - - - ranking = 0.0047403396573669keywords = open (Clic here for more details about this article) |
3/137. Pseudosubluxation of the hip joint. A case report.The case of a 32-year-old man who had a subluxation of his hip joint after open reduction and internal fixation for an acetabular fracture is presented. The subluxation resolved without surgical intervention. It is thought that the subluxation, herein termed pseudosubluxation, is similar to pseudosubluxation seen in the shoulder. The patient had sustained significant trauma to the abductor musculature and lateral hip region with a Morel-Lavelle lesion and a hip fracture coincident with his acetabular fracture. This entity has not been reported previously.- - - - - - - - - - ranking = 3.0047403396574keywords = fracture, open (Clic here for more details about this article) |
4/137. A rare fracture-dislocation of the hip in a gymnast and review of the literature.Posterior fracture-dislocation of the hip is an uncommon injury in athletics and leisure activities. It is more commonly seen in high energy motor vehicle accidents and occasionally in high energy sporting activities. A rare case is reported of posterior fracture-dislocation of the hip joint that occurred in a young athlete during gymnastics. This unusual mechanism of injury illustrates the great forces sustained by the hip joint of gymnasts. Early reduction and operative treatment led to a congruent and stable hip joint. After rehabilitation, she returned to light sporting activities after six months.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
5/137. Telemedical experiences at an Antarctic station.Wintering-over in Antarctica represents a physician's most remote and inaccessible scenario, apart from a space station. Because of the harsh and unpredictable winter weather, Antarctic stations are typically inaccessible for over six months of the year. telephone and fax communication, and recently other forms of telemedicine, have provided vital links to specialists. The author was the sole physician for more than 250 people wintering-over during the 1995 austral winter at McMurdo Station. There were several instances of serious or life-threatening illness where the author relied on teleconsultation. These cases included new-onset coronary artery disease, posterior hip dislocation, complicated colles' fracture and acute appendicitis. There were also numerous consultations for non-emergency clinical presentations normally managed by specialists. telemedicine was a crucial link to specialists from the remote and inaccessible environment of Antarctica.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
6/137. Multisystem involvement in congenital insensitivity to pain with anhidrosis (CIPA), a nerve growth factor receptor(Trk A)-related disorder.Congenital insensitivity to pain with anhidrosis (CIPA), a rare autosomal recessive disorder, is characterized by insensitivity to pain, self-mutilating behaviour, anhidrosis and recurrent hyperpyrexia. It is a hereditary sensory and autonomic neuropathy, also classified as HSAN, due to a defect of the receptor for nerve growth factor. CIPA is the first human genetic disorder caused by a defect in the neurotrophin signal transduction system. This is the first clinical report of CIPA patients characterized on molecular grounds. The clinical phenotypes of our patients show that CIPA is characterized by a multisystem involvement besides the nervous system, including bone fracture with slow healing, immunologic abnormalities, such as low response to specific stimuli, chronic inflammatory state ending in systemic amyloidosis. The molecular characterization allows a better understanding of most of the clinical features.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
7/137. Asymmetrical bilateral traumatic hip dislocation with ipsilateral acetabular fracture.We report a case of simultaneous asymmetrical bilateral traumatic hip dislocation, with one hip dislocated anteriorly and the other posteriorly, with ipsilateral acetabular fracture, suffered in a traffic accident by a 36-year-old man. Closed reduction of both hips was performed, followed by delayed internal fixation of the acetabular fracture.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
8/137. Arthroscopic treatment for traumatic hip dislocation with avulsion fracture of the ligamentum teres.Traumatic hip dislocation in children is a rare condition. Immediate closed reduction is a treatment of choice, but when incongruent reduction results, it can be due to interposition and requires open arthrotomy. We present a previously unreported technique of arthroscopic treatment that was used successfully for traumatic hip dislocation in a 10-year-old girl with impingement of the avulsed ligamentum teres. arthroscopy was effective in confirming the exact nature of the interposition material and excising the fragment with minimal invasion.- - - - - - - - - - ranking = 4.0047403396574keywords = fracture, open (Clic here for more details about this article) |
9/137. Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report.A sixteen-year-old boy involved in a high-speed motor vehicle accident sustained an anterior hip dislocation and avulsion of the anterior ilium extending from the anterior superior iliac spine to the anterior inferior iliac spine. The hip was emergently reduced, and further imaging was obtained to evaluate the bony injury. Computed tomography confirmed the presence of a large displaced bony fragment representing avulsion of the anterior superior and inferior iliac spines and a smaller fragment from the reflected head of the rectus femoris. The patient underwent open reduction and internal fixation of the ilium two days after the initial injury. Postoperatively, he was allowed to bear weight as tolerated with crutches but to avoid active hip flexion. He went on to an uneventful recovery, and at last report (approximately six months after injury), he had returned to full activity. An extensive review of the literature failed to show a similar injury of ipsilateral avulsion of the anterior superior and inferior iliac spines and reflected head of the rectus femoris.- - - - - - - - - - ranking = 0.0047403396573669keywords = open (Clic here for more details about this article) |
10/137. Obturator dislocation of the hip.We describe two patients with obturator dislocation of the hip which was irreducible by described techniques of closed reduction. The first required open reduction using the iliofemoral approach with release of rectus femoris. The second was treated on a traction table which allowed disengagement of the head and, when combined with simultaneous lateral traction, adduction and gradual release of the longitudinal traction, facilitated a smooth reduction. Since the hip is stable in flexion, early mobilisation in an extension-limiting brace avoids the prolonged bed rest traditionally recommended for this injury.- - - - - - - - - - ranking = 0.0047403396573669keywords = open (Clic here for more details about this article) |
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